Velásquez-Girón Eduardo, Buitrago-Quiñonez Edna Rocio, Hernández-Guevara Jorge, Kafury Álvaro Antonio
Arch Bone Jt Surg. 2025;13(1):4-16. doi: 10.22038/ABJS.2024.81116.3702.
Bennett's fracture, the most common intra-articular fracture occurring at the base of the thumb, accounts for less than 1% of all hand fractures. It typically results from specific traumatic mechanisms, deforming forces, and ligamentous injuries. To compare the functional outcomes and sequelae in patients with Bennett's fracture treated surgically using: Open reduction and internal screw fixation, closed reduction and percutaneous fixation, arthroscopy-assisted reduction and screw fixation.
A systematic literature review was conducted to identify studies on Bennett's fracture dislocations in patients over 18 years of age without additional injuries. Searches were performed in PubMed, Scopus, Cochrane Central, Web of Science, Scielo, Lilacs, Oneme, and Epistemonikos databases, with language restrictions in English, French, Spanish, Portuguese, Italian, and German, and no date restrictions. Primary outcome variables included measures of functionality and secondary outcomes such as pain, stiffness, and osteoarthritis.
A total of 18 studies met the selection criteria, with most being retrospective (94.45%). Pain measures were reported in 77.78% of the studies, predominantly using the VAS (min=0 and max=2). All techniques seemed to achieve similar functional outcomes. The main difference was the pain registered at follow-up, mainly by patients treated with open reduction. Osteoarthritis appeared as a common consequence of these fractures, regardless of the treatment type -excluding arthroscopy-assisted reduction as there was not enough data.
The three techniques had similar functional outcomes. Closed reduction and percutaneous fixation appear to result in less pain; however, both closed reduction with percutaneous fixation and open reduction with internal screw fixation have similar rates of osteoarthritis at follow-up. Unfortunately, there is insufficient data to evaluate arthroscopy-assisted reduction with screw fixation, suggesting the need for rigorous follow-up in patients undergoing this surgical intervention.
班尼特骨折是拇指基部最常见的关节内骨折，占所有手部骨折的比例不到1%。它通常由特定的创伤机制、变形力和韧带损伤引起。比较采用切开复位内螺钉固定、闭合复位经皮固定、关节镜辅助复位螺钉固定手术治疗班尼特骨折患者的功能结局和后遗症。
进行系统的文献综述，以确定18岁以上无其他损伤的班尼特骨折脱位患者的研究。在PubMed、Scopus、Cochrane Central、Web of Science、Scielo、Lilacs、Oneme和Epistemonikos数据库中进行检索，语言限制为英语、法语、西班牙语、葡萄牙语、意大利语和德语，无日期限制。主要结局变量包括功能测量指标，次要结局如疼痛、僵硬和骨关节炎。
共有18项研究符合入选标准，大多数为回顾性研究（94.45%）。77.78%的研究报告了疼痛测量指标，主要使用视觉模拟评分法（最小值=0，最大值=2）。所有技术似乎都能取得相似的功能结局。主要差异在于随访时记录的疼痛，主要是切开复位治疗的患者。骨关节炎似乎是这些骨折的常见后果，无论治疗类型如何——不包括关节镜辅助复位，因为数据不足。
这三种技术具有相似的功能结局。闭合复位经皮固定似乎疼痛较轻；然而，闭合复位经皮固定和切开复位内螺钉固定在随访时骨关节炎发生率相似。不幸的是，评估关节镜辅助复位螺钉固定的数据不足，这表明对接受这种手术干预的患者需要进行严格的随访。
